TIP OF THE WEEK

Guardianship Assistance Program

Effective July 1, 2019, caregivers who are at least level 1 licensed and meet other criteria are able to participate in the Guardianship Assistance Program (GAP) if the case is discharged at permanent guardianship with relatives or fictive kin. They may also be eligible for GAP benefits, if they are a licensed foster home.  If the child is 16 or 17 years old when the Guardianship Assistance Agreement is signed, the child can be eligible for the Extension of Guardianship Assistance Program benefits until 21 years old, as long as the child is participating at least one of the qualifying activities. Below are the eligibility requirements and benefits of participating in the program.

Available Caregiver Benefits:

(if criteria are met)

 Monthly payment of $333 for support of the child.

 Medicaid benefits until 18 years of age (or 21 if eligible for   Extension of Guardianship Assistance Program).

 Tuition and fee exemption.

 Available for children living out of state.

 One-time payment to assist with costs of establishing permanent guardianship ($2,000 nonrecurring). 

Local Process:

Specialist:

ü  Create FSFN GAP page.

ü  Attend permanency staffing for level one licensed homes.

ü  Complete Guardianship Assistance Agreement with guardian.

ü  Determine which funding source is appropriate.

ü  Maintain communication and partnership with assigned Case Manager.

Case Manager:

ü  Prepare PG case plan with required information

o    Launch a new Case Plan Worksheet.

o    Remove the parents and add the guardians.

o    Required elements are required to be in the Visitation/Family Time Tab, specifically in the “What are the strengths of this placement” box.

ü  Maintain communication and partnership with assigned GAP specialist.

Program Requirements:

 Must be a licensed home.

 Child is eligible for foster care board payments with

    relative/fictive kin for at least six consecutive months.

 Guardian enters a Guardianship Assistance

    Agreement.

 Permanent Guardianship case plan includes:

-          Program Eligibility: The way the child meets the GAP eligibility requirements.

-          Appropriate Permanency: The way the department determined that reunification

or adoption is not appropriate.

-          Adoption Discussion with Guardian: Efforts to discuss adoption with the child’s permanent

guardian.

-          GAP Discussion with Parents: The efforts to discuss guardianship assistance with the child’s

parent or the reasons why efforts were not made.

-          Appropriate Placement: The reasons why a permanent placement with the prospective

relative is in the best interest of the child.

-          Siblings: The reasons why the child is separated from his or her siblings during placement, if

applicable.

-          Effort to Consult the Child: The efforts to consult the child, if the child is 14 years of age or

older, regarding the permanent guardianship arrangement.

 


Child’s PCP changes with Sunshine Health

The case manager is authorized to change the primary care physician for medical services

How do you change a child’s primary care physician with Sunshine Health Child Welfare Specialty Plan?

  1. Check Integrate (www.integrate.cbcih.com) IMV screen to ensure you’re an authorized caller.

    1. Keeping the IMV screen open can assist you during the process.

    2. Ensure you have the Primary Care Physician’s contact information that you are changing the child to.

  2. Call Sunshine Health Plan at (855) 463-4100 to speak with a representative.

Helpful Hints:

  1. The address to provide Sunshine for SCC children is the Northgate Office (1500 Independence Boulevard, Suite 210, Sarasota, FL 34234).

  1. Obtain the date effective for records.

  2. The Sunshine representative will provide you with a reference number. This reference should be given to the caregiver and/or provided to the physician’s office for treatment.

The following information is needed from the case manager to change the primary care physician

Child’s name:

Child’s date of birth:

Child’s Medicaid number:

Physician’s name:

Practice group name:

Address:

Telephone number:

Physician’s NPI number:

Effective date of change:

If you’re having problems, the WATCH Team can assist.

*Note:  The National Provider Identifier (NPI) is a unique identifier number that applies to many types of healthcare providers.  You may have to call the doctor’s office directly to obtain this information.

 

Child Placement Agreements

What are Child Placement Agreements?

•       Child Placement Agreement means that a Caregiver and a Child Welfare Professional have agreed upon specific care expectations for a child in out-of-home care whose behaviors or circumstances require additional supervision or safeguards.

Who needs a Child Placement Agreement?

•       A Child Placement Agreement needs to be created when there are concerns suspected or dependable information that a child has any of the following:

§  Severe self-harm

§  Problematic sexual behavior

§  Victim of sexual abuse

§  Victim of Commercial Sexual Exploitation of Children

§  Juvenile sexual abuse

§  Behavior(s) that are a significant threat to others

What is the difference between the 2 types of Child Placement Agreements?

•       Care Precautions are considered the least restrictive type of agreement. The requirements are intended to be in place for a short period of time until more information is known about the child. Once more information is known, the child’s placement requirements can be modified as necessary.

•       Behavior Management Plans are needed for children who have demonstrated any of the following behaviors within the past twelve months:

§  Juvenile sexual abuse

§  Behaviors that are a significant threat to others

Who creates Child Placement Agreements?

•       CBC Case Manager will create the Child Placement Agreement with the Caregiver and child and complete document in FSFN.

Who are our local qualified assessors?

•       CPT, CPC, Therapist, Psychiatrist, Psychologist

How are Child Placement Agreements monitored?

•       A Lead Agency POC consult is required within 24 hours of determining that a Child Placement Agreement is needed to help determine which type of plan is necessary.

•       Child Placement Agreements will be reviewed by the Lead Agency POC and the Case Manager Supervisor after development to ensure it keeps the child or other children in the home safe. 

•       The Child Placement Agreement will be reviewed in the 90 day staffing(s)with all participants in attendance along with information reported in the Progress Update

•       Discussions will occur during monthly consults/supervision between the Case Manager and the Case Manager Supervisor.

•       Case Manager will monitor during monthly home visits via discussions with the Caregiver and the child (if age appropriate).

•       Lead Agency POC will attend 6 month staffing(s) unless required to attend a staffing sooner.

What is the process for obtaining information from a qualified assessor?

When a Behavioral PLAN is developed

•       A referral will be made by the Case Manager for an assessment to be completed within the 45 days of initial placement or after determination Behavioral Plan is required.

•       If the child is being considered for a modified or terminated plan then a qualified assessor will be used to review the current plan and behaviors to determine if the plan can be terminated. This process will be completed by the Case Manager.

•       A qualified assessor is not needed for Precaution Plan.

What is the protocol for children being placed with respite care provider?

•       The respite care provider will be made aware during the time arrangements are made by placement that the child has a Child Placement Agreement. The plan will be developed/modified to meet the respite home environment by the Case Manager.

•       If there are no changes to the existing plan then the respite provider will be entered into the FSFN system and a new plan will be printed and brought with the Case Manager to be signed at the time of placement.

What is the protocol for terminating a Child Placement Agreement?

•       For previously created SAR’s a discussion will occur between the Case Manager, Case Manager Supervisor, Lead Agency POC and the Caregiver to determine if the plan is still needed.

•       Precautionary Plans require a consult with the Lead Agency POC, Caregiver, Case Manager, and Case Manager Supervisor to review whether the plan can be terminated.

•       Behavioral Plans require a qualified assessor to complete documentation that the Behavioral Plan is no longer required. Upon receipt of the document by the qualified assessor a consult should be held with the Lead Agency POC, Caregiver, Case Manager, and Case Management Supervisor and any other party needed to discuss terminating the Behavioral Plan or developing a Precautionary Plan.

No plan should be terminated without the appropriate documentation and discussions occurring.

Safety Planning Requirements

Florida Administrative Code defines “Safety Plan” as the specific course of action necessary to control threats of serious harm or supplement a family’s protective capacities implemented immediately when a family’s protective capacities are not sufficient to manage immediate or serious harm threats.” 

A safety plan addresses a specific parent behavior, emotion or condition that results in a child being unsafe.  A safety plan controls and manages danger threats to a child when a parent/legal guardian is unavailable, unable, or unwilling to protect their child.  A safety plan will be in effect as long as a case remains open and parents/legal guardians do not have the protective capacity necessary to protect the child from identified danger threats. 

Safety planning is an ongoing process, not an event and should be developed jointly between the case manager and the family.  The child welfare professional responsible for the case has primary responsibility for developing, monitoring and managing the safety plan. As individual and family circumstances change, safety plans require updates based on the changes.  

In order to have confidence in the sufficiency of the safety plan we must analyze danger threats, family functioning, and family and community resources. This depends on having collected sufficient, pertinent, relevant information. The intention is to arrive at a decision regarding the most appropriate and least restrictive means for controlling and managing identified danger threats and therefore assuring child safety.

The child welfare professional creating, monitoring or modifying the safety plan will:

·         Ensure the safety plan controls the behavior, emotion or condition that results in the child being unsafe

  • Review safety plan for sufficiency within 5 business days of initial case transfer or new assignment and have a Supervisor Consult completed and documented to reflect review and sufficiency of plan

·         Ensure the effect of a safety plan is immediate, and/or continues to protect the child every day

·         Ensure the safety plan describes each specific action necessary to keep the child safe, including:

Ø  The person responsible for each specific action

Ø  Resources or people who will help with each action

Ø  The frequency of the action, including times and days of the week

·         Confirm that the person responsible for each action is occurring as planned at least monthly

·         Ensure the sufficiency of the safety plan as either an in-home, out-of-home, or a combination of both

·         Develop separate safety plans with the perpetrator of domestic violence and the parent/legal guardian who is a survivor of domestic violence

·         NOT include promissory commitments by the parent/legal guardian who is currently not able to protect the child. Example of INAPPROPRIATE safety plan actions include, but are not limited to:

Ø  Mom will not spank

Ø  Parents will remain sober

Ø  Mom will file an injunction and not let the batterer back in the home

Ø  Dad will not use drugs

All new or updated safety plans must be signed by all participants and uploaded into FSFN

within two business days of its creation or modification.

A discussion about the safety plan and specific actions safety plan providers

are responsible for must be documented in FSFN.

 

 

Safety Plans - Modifying

Once a case has been transferred from Investigations to Case Management, it is the Case Manager’s responsibility for developing and implementing modifications to the Safety Plan based on the Case Manager’s ongoing assessment of Safety Plan sufficiency within 5 days of case assignment. The Safety Plan should consist of the least intrusive actions necessary to protect the child consistent with diminished caregiver protective capacities and danger threats.  The Case Manager will exercise due diligence to modify Safety Plans in response to changing family dynamics, including when Conditions for Return are achieved.

A Safety Plan must be modified when any of the following changes occur:

  • A new danger threat has been identified

  • Danger threats have been eliminated

·         A child is released to the other parent, relocated in a family arrangement, or sheltered

·         Parent/legal guardian meets the Conditions for Return

·         There are changes in family dynamics or conditions which change the types and or level of safety services needed, including but not limited to:

Ø  A new child is born or comes into the home

Ø  A parent/legal guardian becomes involved with a new intimate partner relationship

Ø  There are significant changes to the household composition

Ø  There are changes in the availability of a physical location in which the Safety Plan can be implemented

Ø  The Safety Plan needs to become an out-of-home plan

Actions for modifying Safety Plans: 

The primary Case Manager will take the following actions to create a new Safety Plan.

  • Take protective actions immediately in order to keep the child from being harmed

  • To the extent possible, the Case Manager, the parent/legal guardian and any provider involved in the formulation of the original Safety Plan will collaborate to revise the Safety Plan.

Ø  Adhere to special considerations involving domestic violence

Ø  Review and discuss current family dynamics and conditions relative to criteria for an in-home Safety Plan or Conditions for Return

Ø  Review each specific component of the Safety Plan and whether any modifications are necessary

Ø  Identify options for plan modifications needed, eliciting family resources

Ø  Agree on modifications

Ø  Follow up with CLS when a Safety Plan is part of the court order

  • Identify whether there are ways to manage the identified danger threat with the child in the home; and if yes contact safety services providers who will participate in ongoing Safety Plan

  • Consult with your supervisor if assistance is needed in developing a sufficient ongoing Safety Plan.

  • The Case Manager should revise the ongoing Safety Plan and obtain signatures of the parents and any informal Safety Plan providers and file with the court.

FSFN/Documentation for Modifying Safety Plans:

  • Document any safety plan monitoring activity within 2 business days of any assessment information or action related to the assessment of the Safety Plan sufficiency.

  • Document modifications to any existing Safety Plan by terminating the current safety plan in FSFN and create a new version. The date needs to be changed to capture the date of the modification. This will allow for a complete history to the Safety Plans. Upload a signed version within 2 business days of creation.

  • The Case Manager will formally document an updated safety analysis when completing the FFA and any Progress Updates.

  • Supervisor or Case Manager will record supervisor case consultations about Safety Plans within 2 business days using supervisory case consultation functionality in FSFN.

Partnership Plan for Children in Out-of-Home Care

All foster parents must sign and enter into an agreement with the Safe Children Coalition and DCF in order to obtain licensure. Caregivers, however, are not the sole responsible party for ensuring quality care to children who enter out-of-home. Rather, it is a shared responsibility between the biological family, the caregiver, the CBC agency, and DCF. None of us can succeed by ourselves. Success in any case is contingent on the nature and quality of relationships between these key stakeholders throughout the child’s stay in care. The Partnership Plan, a product of the Quality Parenting Initiative, replaces the Bilateral Agreement and is intended to create a more inclusive, collaborative environment that embraces caregivers as partners. This is an integral step in improving and ensuring quality parenting for those children we serve in out-of-home care settings. It is intended to strengthen the depth and quality of the relationship between team members and to refocus organizational culture on partnership and open communication rather than simply on compliance and oversight.

Purpose: To articulate a common understanding of the values, principles and relationships necessary to provide children in out-of-home care with normal childhoods as well as loving and skillful parenting which honors their loyalty to their biological family.

**Effective 2018, each time a child moves placement, a new Partnership Plan must be signed by the Out of Home Caregiver and representative from the Case Management Organization and placed in the child’s file.**

The following are some highlights addressing the relationship between foster parents and case management:

Foster Parent Responsibilities

• Respectful partnership. Professional behavior.

• Participation in development and implementation of case planning. Includes participation in all team meetings or court hearings related to the child’s care and future plans.

• Excellent parenting - trauma sensitive care, family centered practice, and normalcy.

• Effectively advocate for all children’s needs.

• Possess or obtain timely and relevant knowledge and skills to meet the needs of the child(ren) in their home.

• To the best of their ability to provide placement stability and when necessary to participate in thoughtful and individual transition planning.

• To transport and accompany the child to medical, dental, and mental health appointments.

• Accompany and participate fully in children’s appointments for medical, dental, mental health, education and normalcy needs. Sharing of information with team.

• Support child’s attachment to family and assist in visitation and other communication. Mentor family and assist with continuity of care when the goal is reunification.

• Obtain and maintain child’s records important to the child’s well being.

Case Manager Responsibilities

• Respectful partnership. Professional behavior.

• Support and facilitate foster parent’s participation. Provide inclusive process with alternative methods when foster parent cannot be physically present.

• Enable and empower foster parents through services and supports necessary to provide quality care.

• Support foster parent’s role as children’s advocate and to not retaliate against them for their efforts.

• Provide all available information to foster family and assist family in obtaining support, training and skills necessary regarding the children.

• Facilitate cooperation and sharing of information by all involved. Consideration for child’s needs in development of transition planning.

• Facilitate as needed and support foster parent’s participation in meeting child’s needs. Sharing of information. Provide assistance when necessary.

• Provide foster parents with the information, guidance, training and support necessary for implementation of family centered practice.

• Work in partnership to obtain and share records for Child Resource Record, medical, dental, school, special events and achievement and photographs.

Home Visits with Children

What is the purpose of a Home Visit? The purpose of a home visit is to assess the safety and well-being of the child, as well as, address concerns and needs of the child and/or caregivers, determine appropriateness of the placement, and provide the caregivers the support and inform the progress of the case. 

When must a Home Visit be done?

·         Initial face-to face (FTF) contact with the child and caregiver is to occur within two working days after the case is accepted for services at the child’s current place of residence. 

·         When a child is in Shelter Status FTF contact shall occur every seven days.  (Shelter Status=legal status that begins when the child is taken into protective custody of the department and ceases when the court: grants custody to a parent and/or after disposition of the petition for dependency.)

·         Once the child has been Adjudicated Dependant (after Disposition) by the Court, FTF contact is required with each child a minimum of once every twenty five days in the child’s current residence. FTF contacts must occur more frequently when the child’s situation dictates more frequent contact as assessed by the case manager and the case manager supervisor.

·         At least once every three months the case manager will make an unannounced visit to the child’s current residence. 

·         Once a child in run away status returns, a FTF home visit should take place immediately in order to assess the child’s mental/physical state and gain insight into the reason he/she ran away. 

Expectations/Guidelines of a Home Visit:

·         Meet with the child and caregivers in their current residence.

·         Speak with each child individually, alone and away from others, to assess child’s adjustment, progress, needs and/or concerns and overall well-being.

·         Examine the child for cleanliness, health, and signs of injury, abuse and/or neglect.

·         Evaluate the home environment for appropriateness and safety.

·         Discuss concerns and/or needs with the caregiver and provide referrals for services.

·         Discuss stages of change and progress and/or concerns with services.

·         Inform the caregiver and child (if age appropriate) of upcoming court hearings, staffings, etc.

·         Obtain updates and copies of the child’s medical, dental and mental health records, appointments, procedures, prescriptions and dosage.

·         Obtain updates and copies of the child’s educational records and progress (if age appropriate).

·         Observe interactions between the caregivers/family members and the child.

·         Obtain updated photographs of the child using the Mindshare mobile application.

·         Review and sign the Child Resource Record at each home visit to ensure that information is current.

·         Follow up on previous concerns or referrals with caregiver and/or the child.

·         Discuss how visitation is going with parents/siblings.

·         Assess and discuss the Safety Plan in effect with the current participants, their role in the plan and the safety management techniques being utilized to determine if the current safety plan is still effective.

·         Document where the child sleeps and who (if applicable) sleeps in the bedroom with the child.

·         Document home visit information in FSFN or the Mindshare mobile application (which uploads to FSFN) within 48 hours of the FTF visit occurring.

Documenting ‘Other People Present’

When a Case Manager (CM) conducts, or attempts to conduct, a face to face contact with any case participant they must ensure that all people present - household members that are not active case participants, foster siblings/parents, visitors, service providers, etc (‘other people present’) - are included in the Florida Safe Families Network (FSFN) face to face contact.

The CM details observations of interactions between the active case participants and all ‘other people present’; ensuring to detail the children’s interactions with and reactions to these ‘other people present’ in the narrative note. Any tension, verbal arguments or guarded body language is also detailed as to all people present during the face-to-face contact. These observations are critical in accurately assessing risk and bonding; as well as detecting possible threats of harm to the children.

FSFN Documentation of ‘other people present’

When creating a Face-to-Face Contact in FSFN the CM selects all active case participants that were seen or attempted to be seen; then clicks on the blue ‘Add Face to Face Contacts’ hyperlink; which inserts data fields for each of them into the Narrative. Below the active case participants there is an ‘Other Contacts’ header and an ‘Insert’ button. The CM clicks on this ‘Insert’ Button to add each ‘other person present’.

When creating a Face-to-Face Home Visit – Child’s Current Residence in the Mindshare application, CM selects the ‘Add Other Contact’ button, which allows information to be entered in regarding others present during the home visit.

The CM enters the ‘other person present’ name, affiliation, title and date/time the Face to Face occurred in the inserted data fields for that person. Guidelines the CM follows when entering information into the ‘other person present’ data fields are:

• For a Foster Parent or Foster Parent’s child the first name and last initial are entered in the Name box (never entering the last name to respect confidentiality). Example:

Suzy S. SCC Foster Parent 01/11/2019 12:30 PM

John S. (8 y.o.) SCC FP’s Child 01/11/2019 12:50 PM

• For another Foster Child living in the home, only the child’s initials and age are entered. Example:

J.J. (2 y.o.) SCC Foster Child 01/11/2019 12:30 PM

• For a neighbor, family friend, etc demographics and relationship information are obtained and entered into the narrative note as well as ensuring the data fields are filled in Example:

Betty Boop Neighbor Neighbor 01/11/2019 12:55 PM

Notice neighbor is listed twice. The data fields in these inserts are all mandatory so sometimes the affiliation and title will be the same thing.

• For a Service Provider or Professional Agency Involved all information is obtained and entered. Example:

William Jones Helping Hand Social Worker 01/11/2019 1:15 PM

The CM also includes any contact information in the narrative notes for these ‘other people present’ and obtains business cards whenever possible if it is a professional. The CM has the parent sign a release of information for any ‘other person present’ so future communications with said person can occur.

Why is it important to include ‘other people present’ in documentation?

These other people, whether neighbors or professionals, are potential witnesses during the court hearings. They also may be able to assist in locating a parent or child who is missing in the future. They are excellent collateral sources to aide in accurately assessing risk as well.

Note: These same protocols detailed above apply whether the face to face contact is at the home or out in the field such as; the office, a school meeting, a doctor’s appointment etc.

What to Do When A Judge Reunifies Against SCC Recommendations

The following is Best Practice procedures to follow when a Judge reunifies a child with the parent(s) against the recommendations of the Safe Children Coalition (SCC).

If a reunification is ordered that SCC is not in agreement with, the Case Management Supervisor will IMMEDIATELY notify the YMCA SCC Operations Manager and schedule an Emergency Staffing. This staffing must occur within 72 hours of the Judge’s ruling.

The Case Management Agency ensures that all parties/service providers with relevant information about safety and risk to the child are invited to attend the Staffing. If the parties/service providers cannot attend, the Case Manager must obtain written statements from them.

To prepare for the Emergency Staffing the case manager at minimum must:

 See the child and family in the home and observe interactions; on the day of the ruling.

 Complete a Progress Update Home Study to assess the family and to address the change that has occurred.

 Implement a Safety Plan with safety managers to mitigate the danger threat(s).

 Complete the reunification checklist and ensure all required documents are obtained/requested.

 Request updated emergency criminal checks on all household members from the Background Screening Unit.

 Request an address call out history from the law enforcement agency whose jurisdiction it falls in.

 Complete the “Case Review and Consultation Review Form”.

 Determine if the Rilya Wilson Act applies and provide the referral as needed.

During the Emergency Staffing the Team will:

 Discuss the Judge’s ruling, all safety and risk factors and the best interest of the child.

 Develop an action plan to ensure the child’s safety and permanency.

 Review the Safety Plan for effectiveness and other actions that will help ensure the child’s safety.

 Collect the necessary documentation to return to CLS so the case may proceed

 Immediately assist Child Legal Services (CLS) in preparing the appeal (Motion for Rehearing – if it is the path chosen).

The action plan may include:

 Having Child Legal Services (CLS) appeal the decision per Florida Rules 8.265.

 Initiate a deeper level of assessment and documentation before going back to court, or

 Conclude the Team is okay with the ruling, implementing specific measures and actions to address safety concerns.

Ultimately, it is the Judge’s decision! If there are serious safety concerns that were not sufficiently presented during the hearing that the initial reunification ruling occurred in, an appeal hearing must be requested no later than 10 days of that ruling to present the supporting evidence and have that ruling re-assessed by the Judge.

Some ways to avoid reunifications against SCC recommendation from occurring are to: ensure we are making reasonable efforts to provide support and services to the parents, to ensure to maintain monthly or more frequent contact with all providers and parties to the case, to ensure to see the parents face to face every month and to build rapport with them; and most importantly to document qualitatively.

Safety and De-escalation Techniques

When working with diverse clients, behavior can be unpredictable. It is important for everyone to be continually in tune with their surroundings and aware of their own safety.

Techniques for minimizing risk:

  • Ask your agency about safety/emergency procedures and training. Become familiar with written policy and incident reporting.

  • Never take risks with a client who becomes threatening. Leave the room and seek assistance.

  • Eliminate objects in your office or meeting space that can be thrown or used as weapons. Check the physical layout of the office, so you have easy access to the door.

  • Inform your supervisor of all home visits and scheduled activities – time of departure, time of return, etc.

  • Keeping appointments in your Outlook calendar with addresses can assist with determining location.

  • Before entering a home, listen outside the door for any disturbances, such as screaming or fighting. When knocking on the door, stand to the side, not in front of it.

  • Identify potential safety risks while in the home. Remain alert and observant. Position yourself close to an exit with your back to a wall in case you need to get out quickly.

  • After hours, be aware of the location or neighborhood: note streetlights, open spaces, shrubs and other growth that might impair your vision.

  • When going to a car after dark, request to be accompanied by a supervisor or someone else. If you know you will be working late at the office, move your vehicle closer to the building before it gets dark.

  • Use “street smarts”. Plan home visits for daytime hours when possible. Lock car doors, travel without a purse or briefcase, and take on an assertive “I know where I’m going” demeanor. Carry a charged cell phone on you at all times.

  • Never give a client your personal phone number or your home address. Consider having your phone number unlisted or unpublished.

  • Learn the indicators of violence. Never put yourself knowingly in a risky situation. Understand the dynamics of addictions, mental illness, and other issues associated with acting-out behaviors as well as how to recognize signs of agitation. Follow your gut and assess your safety at all times. Learn non-violent self-defense, physical evasion, force deflection, and disengagement skills.

  • Everyone who is not an SCC staff member should enter through the front lobby.

  • Do not prop open, locked doors which lead into the office area.

  • If you see someone in the building you do not recognize, it is okay to ask if you can help them. That will help you determine if they are here for a legitimate reason.

  • Contact the police for an escort if needed. Your supervisor can assist you in determining if this is necessary.

De-Escalation Techniques:

  • Appear calm, centered, and self-assured even if you don’t feel it. Use a modulated, low, monotonous tone of voice.

  • Don’t take things personally. Even if the comments or insults are directed at you, they aren’t about you.

  • Be respectful, even when setting limits firmly or calling for help.

  • Never turn your back for any reason on an aggressive individual.

  • Always be at the same eye level, but do not maintain constant eye contact. Allow extra physical space between you and clients. Keep your hands out of your pockets.

  • Do not get loud or try to yell over a screaming person. Wait until he or she takes a breath; then talk.

  • Empathize with feelings, but not with the behavior. Do not argue or try to convince.

  • Trust your instincts, if you feel the de-escalation isn’t working STOP! Tell the person to leave, call for help, or leave your self.

Critical Junctures

A Critical Juncture is any change to a family’s circumstances which has the potential to impact the safety of a child. Therefore, a Critical Juncture necessitates a re-assessment of the family.  Such times include but are not limited to the following Critical Junctures:

  • When safety management has resulted in a decision to remove a child from home.

  • At the birth or death of a sibling.

  • Upon the addition of a new family member, including intimate partners.

  • Before changing the case plan to include unsupervised visits.

  • Before recommending or implementing reunification as Conditions for Return are met.

  • Before a recommendation for case closure.

  • When case has been dismissed by the court.

A new Progress Update will be created in FSFN at a minimum every ninety days from the

approval date of the Ongoing Family Functioning Assessment OR the approval date of the last Progress Update. A new Progress Update will be created sooner when fundamental decisions are being made for the children, or when Critical Junctures are occurring that necessitate a formal re-evaluation of protective capacities and child needs.

The case manager shall seek a supervisory case consultation to review case dynamics when case circumstances include any of the following. The case consultation will determine if a Progress Update should be completed prior to the 90 day period based on the discretion of the supervisor.

  • When significant changes in family members’ and/or family circumstances warrant a

          review and possible revision to the safety plan and/or case plan, such as a change

          to unsupervised visitation.

  • When an emergency change in a child's out-of-home safety plan placement is

 needed.

  • When the children and/or caregivers are making little or no progress toward the

established outcomes and/or an immediate change in the case plan is needed.

  • After any review (i.e., judicial, administrative, State, or County QA) recommends or

directs that changes be made.

  • At receipt of a new investigation or report of domestic violence in the home.

Supervisory case consultation will be required at Critical Junctures in the development and updating of:

  • Family Functioning Assessments

  • Safety planning/safety monitoring

  • Case planning and

  • Progress assessments.

Supervisor's Role

Strength-based, family-centered practice is proven to positively impact performance measures and outcomes.   Through consults, qualitative discussion, and mentoring, supervisors provide guidance and support to case managers ensuring family-centered services are provided to the clients we serve.  They also serve as an important conduit to management in maintaining practice standards, proactively addressing concerns, fostering critical thinking skills, and looking ahead to help anticipate and overcome barriers.

Supervisors mentor case managers to ensure strength-based, qualitative and timely services are provided.  Regular case consults are a partnership between the supervisor and the case manager to actively help the family create opportunities for improvement and self-sufficiency.  This also provides continual monitoring and evaluation of child welfare case decisions. 

Note: “Open door” supervision is not a substitute for regularly scheduled time with a case manager.  

Supervisor should have regular management supervision to keep them apprised of developments related to service and resource availability, policy and program developments, workload issues, and procedural changes that may impact client service delivery. 

Goals for Supervision

·        Providing a working environment that is supportive and conducive to professional performance.

·        Modeling best practices.

·        Promoting respect for children and families at all times.

·        Consultation.

·        Addressing worker resistance to client personality/behavior.

·        Use resources such as family members, community partners, and foster parents to help in decision-making.

·        Constructive identification of mistakes.

·        Broadening worker understanding of best practice.

·        Addressing caseworker feelings/confusion/ needs.

·        Listening and providing productive feedback.

By focusing on quality service provisions during formal supervision and daily case specific consultation with case managers; supervisors are driving cases in a positive direction for our children and families that will expedite permanency.

Super Supervisor

What is a supervisor?

A supervisor is a mentor, a leader, a coach, a problem solver, a cheerleader, a supporter and a person.  Playing all of these roles and more can be overwhelming but it doesn’t have to be. 

Setting the Tone

Supervisors play a critical role in setting the tone and culture for the team.  The best way to do this is to model the tone and culture you want to establish.  Be confident in your abilities and your staff will become confident in their abilities.  Be honest with staff and staff will be honest with you and with each other.  Give constructive feedback and staff will give constructive feedback.  Pitch in when necessary and staff will pitch in when necessary.  Setting a positive culture for the team is critical to great team work and it begins with the Supervisor.

Supervisor Tools

Guide

- Help staff but, don’t enable staff.  Just as we work with our families to support and encourage behavior change, supervisors work with staff to guide them but, that doesn’t mean providing all of the answers.  Guide staff to discover their own answers by asking those open ended questions like, “What do you think the next steps should be?”

Empower      

-Help staff use their strengths to their full potential and develop new skills.  Utilize staff strengths for the good of the whole team.  If someone is particularly good at time management, let them share their expertise with the team and everyone benefits.  If staff are going to develop new skills they will also need to be allowed to make mistakes.  Creating an atmosphere where mistakes are used a learning opportunities will encourage a culture of growth and innovation instead of fear.

Support         

-Be there for your staff.  Support the work they do and back them up.  Represent staff when interacting with other levels of management.  Pitch in when the need arises.  Don’t ask staff to do anything you would not do yourself.

Educate        

-Give staff the benefit of your knowledge.  Look for those teachable moments when you can share your experience and talent with staff.

-Learn  Let staff see that you do not know everything.  Welcome ideas and assistance from your staff.  Accepting help from staff will encourage them to help each other.

Listen

-We learn much more from listening to others than listening to ourselves.  Take the time to listen to what staff members are saying.  When meeting with staff, do whatever is necessary to focus on them (turn off e-mail, turn off the phone etc.)

Effective supervisors are the key to staff retention.  Staff members who feel empowered, respected, valued and supported are more likely to stay even in the most challenging positions…like child welfare!

 

Building Attachment

Attachment refers to a special emotional and social connection between children and their caregivers that emerges during the first year of life. Securely attached children feel a consistent, responsive, and supportive relation to their caregivers even during times of significant stress.  Insecurely attached children feel inconsistent, punishing, unresponsive emotions from their caregivers and feel threatened during times of stress. 

Two Primary Parenting Behaviors Important in Developing Attachment

1. The adult readily recognizes and responds to the child’s physical and emotional needs.

2. The adult regularly engages the child in lively social interactions. 

Tips to build attachment for maltreated children:

·         Nurture the child(ren)

·         Try to understand the behaviors before punishment or consequences

·         Parent the child(ren) based on emotional age

·         Be consistent, predictable and repetitive

·         Model and teach appropriate social behaviors

·         Listen and talk with the child(ren)

·         Have realistic expectations of the child(ren)

·         Be patient with the child(ren)’s progress and yourself

·         Take care of yourself

·         Take advantage of other resources

Young children need direct, physical contact to sustain healthy attachment relationships that may be qualitatively different with different caregivers. 

 

Childhood Drowning Prevention

 

Florida's drowning death rate among children under age 5 is the highest in the nation.

 In Florida, drowning occurs year round but the highest number drownings occur in the spring and summer. Florida loses more children under age five to drowning than any other state. Over 60% of these drowning deaths occur in residential swimming pools every year.

Among preventable injuries, drowning is the leading cause of death for children 1 – 4 years old. Children less than a year old are more likely to drown at home in the bathroom or a bucket. Among children ages 1 to 4, most drownings occur in home swimming pools. Annually, in Florida, enough children to fill three to four preschool classrooms drown and do not live to see their fifth birthday.

Common household items are involved in many deaths of children under age 5.

  • Infants and toddlers can fall head first into 5 gallon buckets that have very little water in them, and drown. The same scenario applies to toilets.

  • Covered spas or hot tubs that have covers on them are also a threat. Toddlers can get under the cover and go un-noticed.

  • Other household items such as coolers, fish tanks, ponds, or anything else that holds 2 inches or more of water – are drowning hazards for infants and toddlers.

How can we prevent drowning?

  • Any time a child age 5 or under is in the bath tub – maintain constant supervision. Even one minute left alone, could result in drowning. Bath rings or seats have been involved in drowning and do not guarantee child safety. “Children can drown quickly and silently”. (CPSC)

  • Ensure the toilet seat is down. Keep the bathroom door shut and put a safety latch on it to ensure the toddler does not get inside the bathroom without supervision.

  • Never leave containers with water in them around the yard or house. Empty mop buckets, blow up pools and other water vessels immediately after use. Turn the items upside down once emptied to ensure water can not get back in them if it rains.

  • Always secure the safety cover on your spa or hot tub; and put security fencing or alarms around pools.

With the above prevention methods, most of these drowning accidents can be avoided. As a precaution it is also a good idea to learn CPR (cardiopulmonary resuscitation) - it can be a lifesaver.

Swimming Pool Safety:  Layers of Protection

1 SUPERVISION 2 BARRIERS 3 EMERGENCY PREPAREDNESS

Layer 1. Supervision: Supervision, the first and most crucial layer of protection, means someone is always actively watching when a child is in the pool.

Layer 2. Barriers: A child should never be able to enter the pool area unaccompanied by a guardian. Barriers physically block a child from the pool.

Layer 3. Emergency Preparedness: The moment a child stops breathing there is a small, precious window of time in which resuscitation may occur, but only if someone knows what to do. Even if you're not a parent, it’s important to learn CPR. The techniques are easy to learn and can mean the difference between life and death. In an emergency, it is critical to have a phone nearby and immediately call 911.

IDEA - Individuals with Disabilities Education Act

A brief history: In 1982, the U. S. Supreme Court issued the first decision in a special education case in Board of Education v. Rowley, 458 U.S. 176. In Rowley, the Court held that school districts did not have to provide the “best” education for disabled students but merely had to provide services so the child received “some educational benefit.” Rowley established a low standard for a “free appropriate public education”.

 

In 2004, Congress issued their findings, citing “Disability is a natural part of the human experience and in no way diminishes the right of individuals to participate in or contribute to society. Improving educational results for children with disabilities is an essential element of our national policy of ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with disabilities.”

 

Purpose of IDEA:

  • to ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment, and independent living;

  • to ensure that the rights of children with disabilities and parents of such children are protected;

  • to assist states, localities, educational service agencies, and federal agencies to provide for the education of all children with disabilities;

  • to assist states in the implementation of a statewide, comprehensive, coordinated, multidisciplinary, inter-agency system of early intervention services for infants and toddlers with disabilities and their families;

  • to ensure that educators and parents have the necessary tools to improve educational results for children with disabilities by supporting system improvement activities; coordinated research and personnel preparation; coordinated technical assistance, dissemination, and support; and technology development and media services;

  • to assess, and ensure the effectiveness of, efforts to educate children with disabilities.

There are four main parts of IDEA.

 Part A: Provision of IDEA. This section discusses general provisions, including the purpose of IDEA and the definitions used throughout the statute.

Part B: Includes provisions related to formula grants that assist states in providing a free appropriate public education in the least restrictive environment for children with disabilities ages three through 21.

Part C: Includes provisions related to formula grants that assist states in providing early intervention services for infants and toddlers birth through age two and their families.

Part D: Includes provisions related to discretionary grants to support state personnel development, technical assistance and dissemination, technology, and parent-training and information centers.

 

Probable Cause Affidavit

During some cases, you may be required to assist in writing a Probable Cause Affidavit (PCA) to shelter a child from a parent who was once considered non-offending. After speaking with your supervisor, operations and Children’s Legal Services a PCA may be required. Keep in mind that as a case manager, you are unable to remove children; removal is the role of the investigator. Below are some tips and tricks for writing a succinct, yet detailed Probable Cause Affidavit for shelter.

     Information to Include:

1.  Summary of all maltreatments in the allegation section of the PCA.

2.  Date of abuse report (if there is a new report).

3.  Refer to fathers by name, especially if there is more than one father.

4.  Refer to any paramour by name.

5.  Facts and evidence to support removal: The most alarming facts should be included first. All facts should be supported by witnesses or records. Was there a determination of present danger/impending danger? How was that conclusion reached? Include the danger threat and how the diminished protective capacities affect the danger threat to the child.

6.  Explain services provided by case management prior to the point of shelter to prevent removal.

7.  Explain the safety plan process, and why an in-home safety plan is no longer feasible.

8.  Include an assessment of why the children need to be removed right away, especially if there is a time lapse since the concerns developed.

11. Include statements from parents, children (if age appropriate) and others.

12. Assess parent who is not at home/on scene and why they are not appropriate to take custody of the child.

13. Provide facts and evidence in the prior reports that impact on child safety, not only the findings of the reports, i.e. not substantiated, verified, etc.

14. Include a recommendation for visitation level i.e. supervised, four hours, etc.

15. Include a recommendation for placement.

Other Tips:

1. Use proper grammar, punctuation and spelling.

2. Limit the use of “stated” find alternate words (claimed, reported, indicated, etc.).

3. Write formally and do not refer to parents by first name or Mom/Dad.

4. Proofread your writing. Have a supervisor review as well.

5. Be prepared to testify at the shelter hearing.

Motivational Interviewing

Motivational interviewing is a client centered counseling form that assists the practitioner in eliciting behavior change. Clients are helped in exploring and resolving ambivalence. Motivational interviewing is more focused and goal directed, which sets it apart from other methods in which therapists attempt to influence clients to consider making changes.

Motivational interviewing has a wide variety of applications and has been used in areas of substance abuse, health coaching, mental illness, problematic gambling, parenting, coaching, classroom management, intervention for behavior change and dual diagnosis.

Steps of Motivational Interviewing:

  1. Engaging: the process of establishing a working relationship based on trust and respect. The client should be doing most of the talking, as the counselor utilizes the skill of reflective listening throughout the process. Both the client and counselor make an agreement on treatment goals and collaborate on the tasks that will help the client reach those goals.

  2. Focusing: the ongoing process of seeking and maintaining direction.

  3. Evoking: eliciting the client's own motivations for change, while evoking hope and confidence.

  4. Planning: involves the client making a commitment to change, and together with the counselor, developing a specific plan of action. 

Interaction techniques used with Motivational Interviewing include open questions, affirmation, reflective listening, and summary reflections.

Open Questions: invite people to tell their story.

Affirmations: Build confidence in one’s ability to change. They also recognize strengths and behaviors that can lead someone to change.

Reflective Listening: Three types of reflective listening allow for rapport building, building trust and fostering motivation to change. The three types of reflective listening include repeating/rephrasing, paraphrasing and reflection of feeling.

Summary Reflection: Summarizing assists with ensuring that there is clear understanding between the speaker and listening.

 

Homeless Resource Center. 2007. https://www.homelesshub.ca/resource/motivational-interviewing-open-questions-affirmation-reflective-listening-and-summary

Plan of Safe Care- Infants Exposed to Prenatal Substance Use 

Purpose: The Plan of Safe Care for Infants Affected by Prenatal Substance Use (CFOP 170-8) provides guidelines for ensuring mothers, infants (under age one) and family members receive supports to prevent negative outcomes associated with an infant’s prenatal exposure to substance abuse such as controlled substances, misuse of controlled substances or alcohol. All infants and mother’s affected by prenatal substance exposure shall be referred to a home visitor program (e.g., Healthy Start, Healthy Families, etc.) or family support program (e.g., high or very high-risk assessment score) for development of a Plan of Safe Care and care coordination. 

All Infants who have been affected by substance abuse and determined to be ‘Unsafe’ and are involved with case management, judicial or non-judicial, must have a Plan of Safe Care assessment and implementation.

Important Note: A Plan of Safe Care is not the equivalent of a safety plan.  A Plan of Safe Care may identify child safety and risk issues within the family, but a safety plan is the only vehicle for implementing specific protective actions.  A Plan of Safe Care is intended to facilitate a holistic, multi-disciplinary approach to responding to the needs of the entire family.   

Child Protective Investigators: Investigators will be responsible for determining if a Plan of Safe Care is in place or has been offered. If a family has a case plan, the Case Manager will be responsible for completing the Plan of Safe Care. 

Case Manager Responsibilities:  It is the child welfare professional’s responsibility to determine if a Plan of Safe Care had previously been offered to the mother and other caregivers and, if not, re-assess the need for a plan to be implemented and monitored. Upon case transfer, the case manager will evaluate existing Self Care Plans for effectiveness, identify challenges/barriers and monitoring requirements. 

Case managers shall review the pre-birth assessments when newborns are added to the household in existing cases to ensure relevant components of a Plan of Safe Care are being addressed or have been addressed by the existing case plan.  

Case managers shall also review the Plan of Safe Care components to ensure that all identified needs for the mother and infant are met by the initial case plan.   

Plan of Safe Care Components to be assessed in FFA-Ongoing and/or Progress Updates: 

1.       Mother’s Substance Use and Mental Health Needs: substance use history, mental health history, treatment history, medication assisted treatment history and referrals for services. 

2.       Infant’s Medical Care: prenatal exposure history, hospital care (NICU), length of stay, diagnosis, other medical or developmental concerns, pediatric care and follow up, referral to early intervention and other services. 

3.       Mother’s Medical Care: prenatal care history, pregnancy history, other medical concerns, screening and education, follow-up care with OB-GYN, referral to other health care services. 

4.       Family/Caregiver History and Needs: prior involvement with child welfare, child safety or risk concerns, parent-child relationship, family history, living arrangements, current support network, current services, needed support/services. 

 The Plan of Safe Care is a mandatory ongoing assessment process for CPIs and CMs that requires integration into all Family Functioning Assessments and Progress Updates.

Child Placement Agreements

What are Child Placement Agreements?

•       Child Placement Agreement means that a Caregiver and a Child Welfare Professional have agreed upon specific care expectations for a child in out-of-home care whose behaviors or circumstances require additional supervision or safeguards.

Who needs a Child Placement Agreement?

•       A Child Placement Agreement needs to be created when there are concerns suspected or dependable information that a child has any of the following:

§  Severe self-harm

§  Problematic sexual behavior

§  Victim of sexual abuse

§  Victim of Commercial Sexual Exploitation of Children

§  Juvenile sexual abuse

§  Behavior(s) that are a significant threat to others

What is the difference between the 2 types of Child Placement Agreements?

•       Care Precautions are considered the least restrictive type of agreement. The requirements are intended to be in place for a short period of time until more information is known about the child. Once more information is known, the child’s placement requirements can be modified as necessary.

•       Behavior Management Plans are needed for children who have demonstrated any of the following behaviors within the past twelve months:

§  Juvenile sexual abuse

§  Behaviors that are a significant threat to others

Who creates Child Placement Agreements?

•       CBC Case Manager will create the Child Placement Agreement with the Caregiver and child and complete document in FSFN.

Who are our local qualified assessors?

•       CPT, CPC, Therapist, Psychiatrist, Psychologist

How are Child Placement Agreements monitored?

•       A Lead Agency POC consult is required within 24 hours of determining that a Child Placement Agreement is needed to help determine which type of plan is necessary.

•       Child Placement Agreements will be reviewed by the Lead Agency POC and the Case Manager Supervisor after development to ensure it keeps the child or other children in the home safe. 

•       The Child Placement Agreement will be reviewed in the 90 day staffing(s)with all participants in attendance along with information reported in the Progress Update

•       Discussions will occur during monthly consults/supervision between the Case Manager and the Case Manager Supervisor.

•       Case Manager will monitor during monthly home visits via discussions with the Caregiver and the child (if age appropriate).

•       Lead Agency POC will attend 6 month staffing(s) unless required to attend a staffing sooner.

What is the process for obtaining information from a qualified assessor?

When a Behavioral PLAN is developed

•       A referral will be made by the Case Manager for an assessment to be completed within the 45 days of initial placement or after determination Behavioral Plan is required.

•       If the child is being considered for a modified or terminated plan then a qualified assessor will be used to review the current plan and behaviors to determine if the plan can be terminated. This process will be completed by the Case Manager.

•       A qualified assessor is not needed for Precaution Plan.

What is the protocol for children being placed with respite care provider?

•       The respite care provider will be made aware during the time arrangements are made by placement that the child has a Child Placement Agreement. The plan will be developed/modified to meet the respite home environment by the Case Manager.

•       If there are no changes to the existing plan then the respite provider will be entered into the FSFN system and a new plan will be printed and brought with the Case Manager to be signed at the time of placement.

What is the protocol for terminating a Child Placement Agreement?

•       For previously created SAR’s a discussion will occur between the Case Manager, Case Manager Supervisor, Lead Agency POC and the Caregiver to determine if the plan is still needed.

•       Precautionary Plans require a consult with the Lead Agency POC, Caregiver, Case Manager, and Case Manager Supervisor to review whether the plan can be terminated.

•       Behavioral Plans require a qualified assessor to complete documentation that the Behavioral Plan is no longer required. Upon receipt of the document by the qualified assessor a consult should be held with the Lead Agency POC, Caregiver, Case Manager, and Case Management Supervisor and any other party needed to discuss terminating the Behavioral Plan or developing a Precautionary Plan.

No plan should be terminated without the appropriate documentation and discussions occurring.